Current management of primary or secondary antiphospholipid antibody (aPL) syndromes with known embolic phenomena requiring anticoagulation is empiric in the setting of elective orthopedic procedures. Short-term withdrawal of warfarin with continuance of aspirin and glucocorticoid therapy was undertaken for sequential bilateral knee replacements in a lupus patient with aPL. Her course was successfully managed without thrombo-embolic complications.
Harris EN, Asherson RA, Hughes Grv.Antiphospholipid antibodies — autoantibodies with a difference . Ann Rev Med1988; 39: 261-71.
2.
Bowles C.Vasculopathy associated with the anti-phospholipid antibody syndrome . Rheum Clin N Am1990; 16 (2): 471-90. 3. Tan EM, Cohen AS, Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum1982; 25 (11): 1271-7.
3.
Fox IS, Spence AM, Wheelis RF, Healy LACerebral embolism in Libman-Sacks endocarditis. Neurology1980; 30: 487-91.
4.
Sammaritano LR , Gharavi AE, Lockshin MDAntiphospholipid antibody syndrome: immunologic and clinical aspects. Sem Arth Rheum1990; 20: 81-96.
5.
McCarty GAAntiphospholipid Antibodies-Treatable Causes of Many Syndromes. Oklahoma: University of Oklahoma Health Science Center Press, 1990.
Levine SR, Welch Kma.The spectrum of neurologic disease associated with aPL antibodies: lupus anticoagulants and anticardiolipin antibodies. Arch Neurol1987; 543: 876-83.
8.
Babikian VL, Brey RL, Coull BM et al. Clinical and laboratory findings in patients with antiphospholipid antibodies and cerebral ischemia. Stroke1990 ; 21: 1268-73.
9.
Asherson RA , Chan Jkh, Harris EN, Gharavi AE, Hughes Grv.Anticardiolipin antibody, recurrent thrombosis, and warfarin withdrawal. Ann Rheum Dis1985 ; 44: 823-5.
